CIFeR: A novel Clinician-lead Intervention to address Fear of cancer Recurrence (FCR) in breast cancer survivors.

Abstract

12115 Background: FCR affects 50-70% of cancer survivors. There are no validated oncologist-delivered FCR interventions. This multicentre, single-arm study sought to determine the helpfulness, feasibility and efficacy of an oncologist-delivered FCR intervention. Methods: Women were invited to participate if they had completed local treatment, chemotherapy and/or HER2 targeted therapy for early stage breast cancer and had a FCR score >0 on the 42-item FCR Inventory. The brief intervention, delivered by their medical oncologist at routine follow-up, entailed 1) FCR normalisation; 2) provision of personalised prognostic information; 3) take-home education sheet on recurrence symptoms; and 4) advice on managing worry. Consultations were audio-recorded. FCR, need for help, depression and anxiety were assessed before the intervention (T0), and at one week (T1) and three months (T2) after the intervention. Satisfaction with the intervention was assessed at T1. The primary outcome was participant-rated helpfulness. Secondary outcomes included feasibility (response rate, time taken for intervention) and efficacy. Results: Five oncologists delivered the intervention to 61 women (255 women invited; response rate 24%). The mean age was 57 ± 13 years. The mean time since breast cancer diagnosis was 2.5 ± 1.3 years. Forty-three (72%) were on adjuvant hormonal therapy. Overall, 58 women (95%) found the intervention helpful and 59 (98%) would recommend it to others. FCR severity, and the proportion of women with clinically significant FCR decreased significantly over time. There were no significant changes in unmet need, depression, or anxiety. Forty (66%) of consultations were recorded. Mean consultation length was 22 minutes (range 12-37 minutes) and mean intervention length was 9 minutes (3-20 minutes). The intervention was perceived as useful and feasible by oncologists, all of whom have used components of the intervention to help manage FCR in other breast cancer patients. Conclusions: A brief oncologist-delivered intervention to address FCR is helpful and feasible, and has shown preliminary efficacy in reducing FCR. Plans for an implementation study amongst oncologists in Australia are underway. Clinical trial information: ACTRN12618001615279 . [Table: see text]

Patients’ and oncologists’ perspectives on a novel Clinician-led Fear of Cancer Recurrence (CIFeR) Intervention

“…Recently, the CIFeR single-arm Phase I-II study demonstrated that oncologists could deliver CIFeR in eightminutes at a follow up consultation; CIFeR was acceptable, feasible and reduced FCR severity 3-months post-intervention [13][14]. The current qualitative sub-study complements the quantitative CIFeR data, by exploring patients' and clinicians' experiences of receiving and delivering the CIFER intervention.…”

“…Participants Female, early stage (I-III inclusive) breast cancer survivors who had participated in the CIFeR study were eligible [13][14][15]. Inclusion criteria were women: ≥18 years old, at least 6 months to 5 years post-treatment (i.e.…”

“…Inclusion criteria were women: ≥18 years old, at least 6 months to 5 years post-treatment (i.e. surgery, adjuvant chemotherapy and/or radiotherapy) and pro cient in English, with a Fear of Cancer Recurrence Inventory (FCRI) [13][14][15] Severity subscale score > 0.…”

“…Clinicians' perceived the delivery of CIFeR to take 0 -5 mins (n = 2) to 6 -10 minutes (n = 3), which matched objective measures indicating CIFeR delivery took 8 minutes on average. 14 All clinicians indicated they had used CIFeR with patients outside the study and would very likely continue using it in future: "Some women were reporting FCR many years later, and discussion was bene cial. Reminds us of the importance of discussing this topic with every patient during recovery from their treatment phase."…”

Patients’ and Oncologists’ Perspectives On A Novel Clinician Led Fear of Cancer Recurrence (CIFeR) Intervention

“…Recently, the CIFeR single-arm Phase I-II study demonstrated that oncologists could deliver CIFeR in eightminutes at a follow up consultation; CIFeR was acceptable, feasible and reduced FCR severity 3-months post-intervention [13][14]. The current qualitative sub-study complements the quantitative CIFeR data, by exploring patients' and clinicians' experiences of receiving and delivering the CIFER intervention.…”